Do Other Professionals Skip Restroom Breaks And Meals?

[TheCommuter]

I sometimes believe that inpatient bedside nursing is intertwined in a bizarre professional culture where the skipping of bathroom breaks and lunch periods is not only common, but occasionally encouraged by our peers and the powers that be.

Can you name any other professionals who systematically place the needs of their clients above their own?

Countless nursing staff members who work in inpatient bedside settings such as hospitals and nursing homes frequently bypass the breaks to which they are legally entitled. According to a study that was supported by the Agency for Healthcare Research and Quality (2005), nurses are regularly sacrificing their breaks and meal periods to provide patient care. Although many of us already knew that that this practice was going on for quite some time, it does not bode very well for our personal health or job satisfaction.

After all, who wants to work anywhere from eight to twelve hours in a physically demanding role without any breaks?

I can see why numerous nurses explore career options away from the bedside.

According to Fink (2010), while the research confirms what nurses have known for years-few nurses get full breaks; long shifts + heavy responsibility + lack of breaks = fatigue and increased potential for mistakes-part of the blame may lie with nurses themselves. Some nurses forgo their breaks, especially in facilities with toxic work environments, because their callous coworkers or unsympathetic supervisors will endlessly gripe about having to cover an additional patient load during the time away from the floor. Other nurses skip breaks because they feel they might fall further behind with their tasks if they sit down for an uninterrupted lunch or leave the unit to use the restroom.

And even though healthcare facilities must legally pay nonexempt employees who work through unpaid meal periods, the managerial staff at some of these workplaces may subtly discourage nurses from completing 'no lunch' paperwork by taking disciplinary action against workers who submit a large number of these forms.

It is clear that both bedside nurses and the powers that be share some blame for this problem. Facilities need to do their part by encouraging staff to take all legally entitled breaks while taking steps to ease the intense workload.

The workload of bedside nurses can be made more manageable through safe staffing ratios, more streamlined charting, less redundant paperwork, and supportive management. Nurses must do their part by taking all breaks to which they are entitled and willingly covering the patient load of coworkers who wish to leave the floor for a break. Some hospitals employ part-time relief nurses who are on the unit solely to cover for breaks.

In summary, we must take care of our bodies and minds by taking breaks. No reasonable person can work nonstop day after day, year after year without feeling some type of resentment and burnout. To optimally take care of patients, we need to take care of ourselves first.

work-cited.txt

[Andy Droid]

I don't think there's a job on the planet (that involves some sort of responsibility) that doesn't make you miss meal breaks from time to time when things get hectic.

Lots of jobs (mine included) don't allow for people to stop working for half an hour to eat (work load / staffing, etc... just not in the cards to take off for half an hour), so no lunch break is par for the course in my world.

A couple granola bars on the go at work and a crock pot / slow cooker waiting for me when I get home is good enough. (And I prefer a hot meal to a microwaved lunch...)

[OCNRN63, RN]

Uh, did you count them? I have no idea how many times I went to the bathroom in nursing school. It had no bearing on my GPA or my performance as a nurse. What do you mean by the post?

When I was a student, we had to carry around a little booklet that had procedures to check off. There was a section for you to check off for each time you got to go to the bathroom.

[OCNRN63, RN]

That's less than one bathroom break a month. The hydrogen in the water molecules in your bladder must have been fusing into helium.

I have a feeling the poster who talked of "less than 10 BR breaks..." was being sarcastic. At least, I hope so.

[Cold Stethoscope]

I don't think there's a job on the planet (that involves some sort of responsibility) that doesn't make you miss meal breaks from time to time when things get hectic.

Lots of jobs (mine included) don't allow for people to stop working for half an hour to eat (work load / staffing, etc... just not in the cards to take off for half an hour), so no lunch break is par for the course in my world.

A couple granola bars on the go at work and a crock pot / slow cooker waiting for me when I get home is good enough. (And I prefer a hot meal to a microwaved lunch...)

The issue is not "time to time, when things get hectic." The issue is that, for some, it is routine to miss breaks, meals, and bathroom breaks on long shifts. As was stated in other posts, most of the jobs in question don't involve critical safety issues, such as not mixing up meds, not missing something vital, etc., which could cause death or permanent injury. Evidence clearly shows that, beyond a certain stress point, work eficiency decreases and errors increase. It's not a matter of applying the logo to a product crookedly. It is a matter of life and safety.

"Lots of jobs (mine included) don't allow for people to stop working for half an hour to eat...."

And you think that's a good thing? Might there be a marty complex in play? Or might it be better if the staffing levels were high enough that a 30 minute break in the course of a 12- or 16-hour shift could be covered?

I wonder why airline pilots don't have to work under those faux-heroic conditions.

"A couple granola bars on the go..."

Do you really think that's healthy? A couple of granola bars on the go? Why do you even accept your paycheck?

And we wonder why nothing ever changes. The self-sacrificing caregiver attitude prevails, while you give a piggyback ride to the managers as they case their big paychecks and huge bonus checks. But hey, you have your granola bars, and dang it, that's enough!

Why in my grandpa's day, they hardly had time to stop for their daily lunch of a bowl of steam...

[Andy Droid]

As was stated in other posts, most of the jobs in question don't involve critical safety issues, such as not mixing up meds, not missing something vital, etc., which could cause death or permanent injury. Evidence clearly shows that, beyond a certain stress point, work eficiency decreases and errors increase. It's not a matter of applying the logo to a product crookedly. It is a matter of life and safety.

part of what I do is maintain the systems that monitor for pathogens and other impurities in water supplies for a few communities.

if you screw up badly, a few people could die.

if I screw up badly, a few thousand people could die.

I get the whole stress / overworked can cause mistakes thing.... I really do.

But... we don't all work at hospitals that have an infinite budget to be able to have staff coming out the wazoo, so everyone can go at a leisurely pace... stop what they're doing for a half hour lunch... maybe take a 10 minute coffee break every other hour... smoke breaks on alternating hours... leave right at the end of their scheduled shift....

(yes, that was sarcasm )

Sure, in a perfect world the above would be everyones working conditions... but in the real world, you do your best to do your job with the resources (in a time and staffing kinda way) you have at your disposal.

If me skipping the idea of a sit down lunch and grabbing something on the go means I keep more stuff working properly, then so be it... it's only a 12 hour shift... I'm not going to starve, and I'm not hypoglycemic. (and to be honest, I'd much rather eat at home when I get home.... the food is freshly cooked instead of nuked, and I know everything around me is clean, as opposed to possibly sitting at a table someone just sneezed on or something.... and I KNOW I'm not going to be interupted)

[Cold Stethoscope]

Andy Droid, it doesn't take an infinite budget to maintain safe staffing levels. If a nurse is so pressed that she has to grab a granola bar in a 12-hour shift because her patients might be in danger otherwise, or can't even take a bathroom break for the same reason, then something is very wrong.

I don't think you have any idea what the responsibilities of a med/surg, ICU, PICU, etc. are. Do you generally have to deal with people's heart stopping, blood chemistry suddenly going haywire, and so on in your job? I'm sure some security guards have similar attitudes, because, you know, lives could be in danger if someone breaks in.

On critique I have of Americans (and I am one) is that they know precious little of what goes on beyond their borders. Somehow hospitals in other countries manage to provide non-martyr working conditions, and yet they provide care at a much lower per-patient cost, even taking salaries into account. How do they do it? Is it magic?

It takes a lot of missed lunch breaks to pay for the CEO's bonus. It takes a lot of missed bathroom breaks to pay for the uncompensated care the hospital provides to the community through its emergency room.

But hey, you never know when a bunch of samurai-sword-wielding ninja pathogens will kick out the sides of your drinking water reservoir.

By the way, in your job, if you screw up badly, people could die. In nursing, if you screw up a little bit, or miss one measly detail, the patient could suffer the consequences for the rest of his life-or he could die. Would you really want your child to be taken care of by someone so frazzled at he's only had a granola bar to eat in the past 11 hours, as he's running from room to room, while he dehydrates himself so his bladder doesn't burst? Do you really think your job is that moment-to-moment critical?

[txredheadnurse, BSN, RN]

One thing I haven't seen addressed in this thread so far regarding the "only takes two minutes to pee" school of thought is the fact that quite a few of the facilities I am in every week have, in my opinion, a pathetic lack of staff bathrooms and/or break areas. Many of the nursing facilities I visit have as few as 1 staff bathroom for the entire facility: nursing, housekeeping, dietary, rehab and admin staff numbering perhaps 50 people in total during a week day shift all sharing 1 bathroom. The logisitics of getting there from your primary work location plus the very real chance that when you do get to the bathroom it is already in use definitely add up and make it more than a "two minute" chore to urinate.

The break room situations can be as bad. Almost every multistory facility I enter has 1 break room for the entire building; not one per floor. Other places have a converted storage closet which barely contains a mini fridge, compact microwave, table and four chairs. You had better be OK with being very cosy with your co workers if you have to take a meal break in there because you will be literally rubbing elbows when you try to eat. So even if the management implements a break time policy of staff relieving each other there is nowhere for them to go on site or what is available is inadequate for more than 4-5 people to take a meal break at any given time.

One last thing about eating on the go, keeping snacks in your pockets. Most of the facilities I have worked at or currently visit for audits have policies forbidding the carrying of food and snacks in your uniform or eating at the nurses station or in the hallways so one runs possible disciplinary action if you try to munch on that magic granola bar.

No nursing is not the only job or profession that expects people to be interchangable with machines and run constantly during the work day without a break. However just because we aren't alone in suffering from this maladaptive management style doesn't make it OK or just something we should accept and never mention or attempt to change. I personally have been subject to disciplinary action because I took a bathroom break instead of literally voiding on myself. I quit that job and I spread the word widely among all my friends about how that particular company treats it staff. And this was a non clinical utilization review job. The company had contracted to keep telephone hold times down to less than two minutes but they refused to hire enough nurses to answer the phones so that people could take bathroom breaks. I told my supervisor that I had to go to bathroom an hour before I finally did leave my desk and she repeatedly refused to relieve me. Finally I had to take care of my needs and returned (more than 2 minutes but less than 6 minutes) later to find a write up on my desk. I quit at the end of the day. So realize that there can be consequences for simply trying to take care of basic biological needs if an employer choses to view one as less than human or worthy of basic respect.

[KaeliF]

I'm a brand new nurse, been on my own for three weeks after a 1 month orientation. Out of three weeks I've only had lunch two of those days and used the restroom once. For me, I'm still so focused on trying to get everything done that usually don't even notice that I haven't peed or eaten for 12 hours. I've just gotten used to it. Although I can definitely tell that I am thinking much less clearly by the end of my shift and I think that has to do with low blood sugar.

[joanna73, BSN, RN]

You have labour laws in place for a reason. Breaks are supposed to be mandatory, not a privilege. That's exactly why burnout is so high in nursing. On a side (but related) note, in many countries, health care is universal, a right for citizens (ie: Canada, Australia, UK). While each system has their flaws, you have to wonder why the US economy is still in such terrible shape if the system is working. Clearly, something is flawed there.

[Been there,done that, ASN, RN]

I'm wondering if anyone on this forum is or has been employed in a Magnet Hospital. I hear they're supposed to be nurse-friendly. Anyone out there have experience in one of them? Is it any better? Do nurses feel empowered to effect change?

Worked in two magnet hospitals ,, recently.

They are the WORST . Review the Magnet criteria.

[blondy2061h, MSN, RN]

I always use the bathroom when I need to. It takes 2 minutes, and we have a staff bathroom right on the unit. Sometimes I have to hold it for a bit, but I eventually go. I don't always get an uninterrupted 30 minute lunch break, but I can always at least choke down a sandwich while charting. My boss is okay with covered drinks at the nurses' station, so a bottle of pop or water is okay. We don't get a lunch break deducted from our pay, so that's nice and makes me less irritable about only having 10 minutes to eat before the aid comes to get me to tell me rm 7 needs something for pain.

Everytime I see people doing road work in 100 degree temperatures with cars swerving past them at 70 mph I'm thankful for my job.

[blondy2061h, MSN, RN]

Worked in two magnet hospitals ,, recently.

They are the WORST . Review the Magnet criteria.

I work in a magnet hospital and I think my conditions and our nurse/patient ratios are pretty good compared to most of what I read here.